Patient Education

Elbow

Care and Management

Arthroscopic Debridement of the Elbow

During this outpatient procedure, the surgeon examines the inside of the elbow joint with a camera called an arthroscope. The surgeon identifies and corrects problems with the bones, ligaments and tendons of the elbow.

Aspiration of the Olecranon Bursa

This outpatient procedure relieves pain and swelling in the elbow caused by bursitis, or inflammation of the bursa. The bursa is a fluid-filled sac between the skin and bones of the elbow.

Cubital Tunnel Release

This surgery treats cubital tunnel syndrome. That’s a compression or irritation of the ulnar nerve at the elbow. During this surgery, the nerve is given more room.

Medial Epicondylectomy

This outpatient procedure, performed under general or regional anesthesia, removes the medial epicondyle (the bony bump on the inner side of the elbow) to alleviate compression of the ulnar nerve. Medial epicondylectomy is used to treat cubital tunnel syndrome.

Medial Ulnar Collateral Ligament Reconstruction (Tommy John Surgery)

This procedure is designed to repair a torn elbow ligament – an injury typically caused by strong, repetitive overhead throwing motions of the arm or by dislocation of the elbow. It was first performed in 1974 on baseball pitcher Tommy John.

PRP Therapy (Overview)

Platelet rich plasma therapy can help injured joints and other problems. It uses parts of your own blood to reduce pain and speed up healing.

Radial Tunnel Release

This surgery treats radial tunnel syndrome. That’s a compression of the radial nerve. During this surgery, the nerve is given more room.

Ulnar Nerve Transposition

This surgery relieves pressure on the ulnar nerve at the elbow. It moves the nerve to keep it from being compressed by the medial epicondyle (a bony bump on the inner side of your elbow).

Conditions

Biceps Tendonitis (at the Elbow)

This is a problem with a tendon in your elbow. It’s called the “distal biceps tendon.” It connects the biceps muscle of your upper arm to the radius bone at the elbow. With this condition, the tendon becomes painfully inflamed or irritated.

Cubital Tunnel Syndrome

This condition, also called “ulnar nerve entrapment,” happens to the ulnar nerve in your elbow. This nerve travels along the inner side of your elbow and down to your hand. It’s the nerve that makes the jolt you feel when you bump your “funny bone.” With this condition, your ulnar nerve is compressed, stretched or irritated.

Elbow Bursitis

This is a swelling of a fluid-filled sac in the back of your elbow. This sac is called the “olecranon bursa.” You have similar sacs near other large joints throughout your body. They act as cushions between your bones and your soft tissues. Normally they have a small amount of fluid inside them. But sometimes they can swell. That is called “bursitis.”

Growth Plate Injuries of the Elbow

Growth plates are places where new bone tissue forms. They are found near the ends of the long bones in growing children. Growth plates are weaker than the surrounding bone. That makes them easier to injure.

Hyperextension Injury of the Elbow

This happens when you extend your elbow back farther than it’s supposed to go. That damages the bones and soft tissues in your joint. Hyperextension can dislocate or even fracture your elbow.

Lateral Epicondylitis (Tennis Elbow)

This condition, commonly called tennis elbow, is an inflammation of the tendons that connect the muscles of the forearm to the elbow. The pain is primarily felt at the lateral epicondyle, the bony bump on the outer side of the elbow.

Medial Epicondylitis (Golfer’s Elbow)

This condition, commonly called golfer’s elbow, is an inflammation of the tendons that connect the muscles of the forearm to the elbow. The pain is primarily felt at the medial epicondyle, the bony bump on the inner side of the elbow.

Osteochondritis Dissecans of the Elbow

This is a disorder that most often affects young athletes. It happens when part of a bone in the elbow loses its blood supply. It weakens, and so does the cartilage that covers it. Bone and cartilage may break off and drift around in the elbow. That can cause the joint to catch and lock up.

Overuse Injuries of the Elbow

If you are an athlete, or if you work with your arms and hands, your elbows may be at risk for an overuse injury. This is an injury caused by repetitive motions. This type of injury can be a problem for people who play sports such as tennis or baseball. Children also have a higher risk, because their bones are still growing.

Radial Tunnel Syndrome (Entrapment of the Radial Nerve)

This condition involves the radial nerve in your elbow. The radial nerve passes down your arm to your hand. Its branches travel into your thumb, forefinger and middle finger. With this condition, your radial nerve is compressed, stretched or irritated.

Throwing Injuries of the Elbow

Throwing overhand again and again puts a lot of stress on your elbow. It can lead to injury. Young athletes, in particular, are at risk. Some play sports all year without learning how to throw properly. And, their bones are still growing. Let’s look at how the elbow can be damaged.

Triceps Tendonitis

This is an inflammation of a tendon at the back of your elbow. It’s called the “triceps” tendon. It anchors your upper arm’s triceps muscle to the ulna (one of the bones of your forearm).

Ulnar Collateral Ligament Injury

Like other joints, the elbow is held together by strong bands of tissue called “ligaments.” On the elbow’s inner side is the ulnar collateral ligament complex. We call it the “UCL.” It’s made of three bands that connect the humerus (the upper arm bone) to the lower arm’s ulna. The UCL is the elbow ligament most often injured by baseball pitchers and by other athletes who play throwing sports.

Foot, Ankle and Lower Leg

Care and Management

Ankle Fracture Surgery

This surgery fixes an unstable break in your ankle. The break could be in the small bone of your lower leg, called the “fibula” or the larger bone, called the “tibia.” Sometimes, they’re both broken. Your surgeon will stabilize your bones so your ankle can heal.

Ankle Fusion, Transfibular

This surgical procedure is performed to treat severe arthritis or injury of the ankle joint. During the procedure, the surgeon removes damaged bone and cartilage and fuses the joint. This stabilizes the ankle and relieves pain.

Arthroscopic Articular Cartilage Repair (Ankle)

This minimally-invasive procedure is performed to stimulate the growth of fibrocartilage in an injured joint. Fibrocartilage is a tough, dense, fibrous material that can fill in areas where smooth, glassy cartilage has become damaged or worn away. This procedure may be performed with general or regional anesthesia.

Arthroscopy of the Ankle

This procedure identifies and treats problems in your ankle. With it, the surgeon can access your ankle without creating a large incision.

Calcaneal Fracture Fixation (Open Reduction and Internal Fixation)

This procedure is used to correct a severe fracture of the calcaneus (the heel bone). During this procedure, the surgeon stabilizes the bone with hardware to allow the bone to heal properly.

This procedure is used to correct a “tongue-type” fracture of the calcaneus (the heel bone). During this procedure, the surgeon stabilizes the bone with hardware to allow the bone to heal properly.

Debridement of the Achilles Tendon

This outpatient procedure is designed to repair a damaged Achilles tendon. During the procedure, injured and scarred tissue is removed. This can reduce or eliminate the pain of tendinitis.

Fixation for LisFranc Injury

This procedure uses screws to repair broken or dislocated bones in the midfoot.

Jones Fracture Fixation (Intramedullary Screw)

This procedure is used to correct a Jones fracture – a fracture of the fifth metatarsal bone of the foot. During this procedure, the surgeon inserts a screw into the metatarsal to stabilize the bone and allow it to heal properly.

Jones Fracture Fixation (Open Reduction and Internal Fixation)

This procedure is used to correct a Jones fracture – a fracture of the fifth metatarsal bone of the foot. During this procedure, the surgeon inserts one or more screws (and sometimes additional hardware) to stabilize the bone and allow it to heal properly.

Kidner Procedure

During this outpatient procedure, the physician removes a problematic accessory navicular bone. The accessory navicular is an abnormal, unnecessary bone found in a small percentage of people. It is located on the inner side of the foot.

Lateral Ankle Ligament Reconstruction

This procedure is performed to correct chronic ankle instability that has not responded to treatment such as physical therapy. Ankle instability occurs when ligaments are stretched or torn. A simple repair, known as the Bröstrom-Gould technique, is ideal for athletes who need to retain full range of motion.

Metatarsal Fracture Fixation (Open Reduction and Internal Fixation)

This procedure is used to correct a fracture of one or more of the long bones of the foot. During this procedure, the surgeon stabilizes the bones with hardware to allow the bones to heal properly.

PRP Therapy for Achilles Tendon Pain

If you have pain in your Achilles tendon, platelet rich plasma therapy may help. It uses parts of your own blood to help your body heal itself. PRP can help your ankle feel better and work better.

PRP Therapy for Peroneal Tendonitis

If you have painful tendons on the outer side of your ankle, platelet rich plasma therapy may help. It uses parts of your own blood to help your body heal itself. PRP can help your ankle feel better and work better.

PRP Therapy for Plantar Fasciitis

If you have pain in your foot from plantar fasciitis, platelet rich plasma therapy may help. It uses parts of your own blood to help your body heal itself. PRP can help your foot feel better and work better.

Subtalar Fusion

This surgical procedure is used to help relieve pain in the joint beneath the ankle joint and correct deformities in the hindfoot caused by injury, arthritis, or genetic defect. The procedure fuses the calcaneus (the heel bone) to the talus, the bone that connects the foot to the ankle.

Surgery for Achilles Tendon Rupture

This surgical procedure is used to repair a ruptured Achilles tendon, the large tendon that travels down the back of the ankle. This procedure will help the tendon heal properly, restoring function to the foot and ankle.

TightRope™ Fixation for Ankle Syndesmosis

This technique is used to stabilize an ankle after injury. It can be used to repair a high ankle sprain, which damages the soft tissue structures between the tibia and fibula and causes these bones to separate. It can also be used to stabilize a fracture of the fibula. The TightRope system anchors the ends of the tibia and fibula together with a braided polyethylene cord, rather than with a rigid surgical screw, to restore the original position of the bones and to allow for proper healing.

Total Ankle Joint Replacement (STAR™ Mobile-Bearing)

This surgical procedure is performed to remove portions of the ankle that are diseased or severely injured and to implant a device that will help manage pain and restore mobility to the ankle.

Triple Arthrodesis

This surgical procedure is used to help relieve pain in the ankle joint and correct deformities in the hindfoot caused by injury, arthritis, or genetic defect. The procedure fuses the three main joints in the hindfoot that allow side-to-side movement – the calcaneo-cuboid, talonavicular, and subtalar joints.

Conditions

Accessory Navicular Problems

An accessory navicular is an extra bone on the inner side of your foot. It’s connected to the bone we call the “navicular,” which helps form the foot’s arch. Most people don’t have an accessory navicular, and you can have one and not know it. But in some people, this extra bone causes problems.

Achilles Tendon Injuries

The Achilles tendons are thick and powerful bands of fibrous tissue. They connect your calf muscles to your heel bones. The tendons help you walk, run and jump. And that means they are under a lot of stress, making injuries to the Achilles tendons common.

Adult Acquired Flatfoot

This is a collapse of your foot’s arch. It happens over time, usually in just one foot but sometimes in both. As your arch collapses, the bones of your foot may gradually shift out of alignment. This can cause pain and other problems.

Ankle Sprains

Ligaments are fibrous, elastic bands of tissue that connect and stabilize the bones. An ankle sprain is a common, painful injury that occurs when one or more of the ankle ligaments is stretched beyond the normal range of motion. Sprains can occur as a result of sudden twisting, turning or rolling movements.

Cavus Foot (High-Arched Foot)

This condition is an abnormally high arch of the foot that results in an excessive amount of body weight being directed to the ball and heel of the foot. Cavus foot can be congenital or acquired, may develop at any age, and can affect one or both feet.

Charcot’s Neuroarthropathy (CN)

This condition, which most often occurs as a complication of long-term diabetes, is a progressive degenerative condition that affects the foot. It is characterized by nerve damage in the foot along with severely weakened foot bones. This combination can result in a person fracturing the foot, but continuing to walk on the broken bones, which leads to debilitating foot deformity.

Chronic Lateral Ankle Pain

This is a pain on the outer side of your ankle. It’s a lasting pain that you may feel all the time. It can make it hard for you to walk and run, and it can increase the possibility of ankle sprains.

Diabetic Foot

This term is used to describe foot problems that stem from diabetes. These problems can be difficult to treat.

Fracture of the Heel Bone (Calcaneus)

This condition is a break in the heel bone, called the calcaneus, which forms the back of the foot. This bone supports the foot and is important for normal walking.

Fracture of the Talus

This condition occurs when the talus, a bone that connects the foot and ankle, develops a fracture from a severe impact or fall. The talus is an important bone of the foot, as it aids in walking on uneven ground and in weight transfer across the ankle joint.

Gout

This is a form of arthritis. It causes pain and swelling in your joints. For many people, it starts in the big toe.

Haglund’s Deformity (Retrocalcaneal Bursitis)

This condition is a bony enlargement on the back of the heel that can aggravate the retrocalcaneal bursa, a fluid-filled sac located on the back of the heel between the Achilles tendon and the calcaneus. The bursa can become inflamed and swollen, a condition called bursitis. Haglund’s deformity most commonly affects young women.

Hallux Rigidus (Stiff Big Toe)

This is a type of arthritis that affects the base of the big toe. It forms in the metatarsophalangeal joint (we call it the “MTP” joint). With hallux rigidus, the protective cartilage on the ends of these bones wears away. Bone rubs against bone. Bony growths called “bone spurs” may form. Your toe stiffens, and this can make walking uncomfortable.

High Ankle Sprain (Syndesmosis Ligament Injury)

This condition is a sprain of one or more of the ligaments that hold the tibia and fibula together at the ankle. This joint, called the ankle syndesmosis, is made up of ligaments on the front and rear of the ankle, and in the space between the tibia and fibula.

Jones Fracture

This is a break of a bone in the foot called the “fifth metatarsal.” It’s on your foot’s outer side, behind the little toe. With a Jones fracture, this bone breaks on the end furthest from the toe. The fifth metatarsal doesn’t have a good blood supply there, so healing can be difficult.

Lisfranc Injury

This is an injury of the middle part of the foot, where the metatarsal bones of the forefoot connect to the cuneiform bones of the midfoot. It can involve torn ligaments, broken bones or a combination of both. And, it can involve more than one joint.

Metatarsalgia

The ball of your foot absorbs a lot of stress when you run and jump. It can become injured and sore. We call this pain “metatarsalgia.” The pain can keep you from exercising and from playing sports. And it can be a problem for active people.

Navicular Stress Fracture

This condition is an injury to the navicular, one of the tarsal bones of the midfoot. This type of injury is common in athletes, particularly those who participate in high-impact sports that require jumping, sprinting and sudden directional changes. Track and field athletes are particularly susceptible.

Osteochondral Injuries of the Talus

The talus, lined with articular cartilage, connects to the tibia and fibula to make up the ankle joint. An osteochondral injury occurs when the talus and/or surrounding cartilage is bruised, fractured, or chipped from an injury.

Peroneal Tendon Tears

This condition is a tearing of one or both peroneal tendons, which travel down the lower leg, behind the lateral malleolus and along the outer side of the ankle.

Peroneal Tendonitis

This condition is an inflammation of one or both peroneal tendons, which travel down the lower leg, behind the lateral malleolus and along the outer side of the ankle.

Pilon Fractures

This injury is a fracture at the base of the tibia (the largest of the two bones in the lower leg). Pilon fractures involve the weight-bearing surface of the tibia, and typically occur just above the ankle. In many cases, when the tibia is fractured, the thinner bone in the lower leg (called the fibula) is also broken.

Posterior Tibial Tendon Dysfunction (PTTD)

This condition is an overstretching and inflammation of the posterior tibial tendon, which travels from a muscle in the calf down to the arch of the foot. This tendon is one of the major supporting structures of the foot’s arch and aids in walking.

Rheumatoid arthritis, a condition that can attack joints throughout the body, commonly affects both feet and both ankles at the same time. It can cause the joints to become swollen and possibly deformed, causing disability.

Stress Fractures of the Foot and Ankle

Stress fractures are one or more tiny cracks in a bone. These fractures are common in the legs and feet. That’s because your legs and feet have to support your weight and absorb the forces of walking, running and jumping.

Tibial Fractures

This is a break of the shinbone. That’s the larger of the two bones in the lower leg. Tibias are strong bones that support most of your body’s weight.

Hand

Care and Management

Basal Joint Surgery

Pain in the basal joint caused by arthritis makes it difficult for patients to grip and hold or twist objects between the thumb and fingers. This surgical procedure removes and rebuilds the basal joint.

Carpal Tunnel Release (Open Technique)

This surgical procedure treats the pain of carpal tunnel syndrome. It relieves pressure on a nerve that travels through your wrist. This nerve is called the “median” nerve.

De Quervain’s Release

This outpatient procedure relieves the symptoms of De Quervain’s tenosynovitis by releasing the tendon sheath that wraps around the tendons at the base of the thumb. This relieves pressure and friction on the tendons, allowing them to glide freely.

Distal Radius Fracture Repair with Volar Plate

This procedure uses a metal implant to stabilize a fracture in the radius near the wrist. The radius is the largest of the two bones of the forearm.

Electromyography (EMG)

This is a test of your muscles and nerves. It usually has two parts. One is a nerve conduction study. This measures how well electricity moves through your nerves. The second part is a needle electromyogram. It records the electrical signals your muscles make when you move them. The results can help your doctor find problems linked to certain disorders or conditions.

Endoscopic Carpal Tunnel Release

This procedure is performed to relieve pressure on the median nerve, alleviating the pain of carpal tunnel syndrome and restoring normal sensation to the hand and fingers. The endoscopic technique, performed on an outpatient basis, creates less pain and scarring than traditional open surgery and allows for a quicker recovery.

Finger Fracture Fixation

This procedure uses pins, screws or metal plates to repair broken bones in the fingers. The actual fixation method will depend on the location and pattern of the break.

Finger Joint Fusion (DIP Joint)

This outpatient procedure is used to resolve the pain of a severely arthritic joint of the finger by permanently stopping finger movement. This is most commonly used for the joint nearest the fingertip, called the DIP joint, although any joint in the finger can be fused.

Ganglion Cyst Removal

This outpatient procedure is used to remove a ganglion cyst, a fluid-filled sac that forms as a herniation from a joint capsule, ligament or tendon sheath. Ganglion cysts commonly develop at the wrist.

Limited Palmar Fasciectomy for Dupuytren’s Contracture

This surgical procedure is performed to treat fingers that have become flexed because of Dupuytren’s contracture. In this procedure, the thickened and contracted part of the fascia – the layer of tissue just beneath the skin – is removed. There are many variations of this surgery based on the severity of the condition.

Needle Aponeurotomy for Dupuytren’s Contracture

This minimally-invasive, non-surgical office procedure is used to help straighten fingers that have become bent by Dupuytren’s contracture. A small needle is used to cut the contracted cords that cause the contracture and prevent the finger from fully extending.

Nerve Conduction Study (NCS)

This noninvasive, outpatient exam is used to measure how quickly nerves conduct electrical signals through the body. NCS is a valuable technique for diagnosing nerve damage. If damage exists, NCS can help a physician find its source.

Scaphoid Fracture Open Reduction and Internal Fixation (ORIF)

This procedure stabilizes a fractured scaphoid bone with screw fixation. The scaphoid is an important carpal bone of the wrist, which is critical in coordinating motion of the other carpal bones and the radius.

Tendon Repair

This procedure, performed under general anesthesia, is used to repair a ruptured or severed tendon in the finger or thumb.

Trigger Digit Release

During this minimally-invasive procedure, the surgeon opens a narrowed tendon pulley at the base of a finger or thumb affected by trigger digit. Opening the pulley prevents the nodule from catching, allowing the the affected digit to flex and extend normally with no triggering or pain.

Wrist Arthroscopy

This minimally invasive outpatient procedure allows the surgeon to evaluate and treat injuries and disorders of the ligaments, cartilage, and bones of the wrist. The surgeon uses a small camera, called an arthroscope, and tiny instruments which are inserted through small incisions in the wrist.

Conditions

Basal Joint Osteoarthritis

This condition is a degeneration of cartilage in the joints at the base of the thumb, collectively called the basal joint. The main component of the basal joint is the thumb carpometacarpal (CMC), joint. This joint, which allows the thumb to pivot and swivel, can wear out even early in life.

Boutonniere Deformity

This condition is a characteristic deformity of the finger in which the finger’s middle joint, called the PIP joint, bends downward and the finger’s end joint, called the DIP joint, hyperextends.

Boxer’s Fracture

A boxer’s fracture is a break of the metacarpal of the little finger. The metacarpals are the long bones in the hand that connect the fingers to the wrist. A boxer’s fracture refers to a break at the end of the bone nearest the knuckle, which is called the metacarpal neck.

Carpal Tunnel Syndrome

Pain, numbness and tingling in your hand may be from carpal tunnel syndrome. It happens when the area around the main nerve to your hand is too tight. The nerve is called the median nerve. And the small space in your wrist where it passes is called the carpal tunnel.

Colles Fractures

Colles fracture is a break of one or both of the forearm bones (called the radius and ulna) that occurs just above the wrist. Although this type of injury can be caused by any strong force, Colles is most often associated with trying to break a forward fall.

De Quervain’s Tenosynovitis

This condition, also called stenosing tenosynovitis of the first dorsal compartment of the wrist, is an inflammation of the sheath that wraps around the tendons at the thumb side of the wrist.

Distal Radius Fracture (Broken Wrist)

This condition is a break of the radius bone at the wrist. The radius is the larger of the two bones that connect the wrist to the elbow. The other bone is called the ulna. The radius supports the majority of forces at the wrist joint with its large joint surface. A fracture of the distal end of the radius – the end nearest the wrist -is one of the most common types of fractures. It may be part of a complex injury that involves other tissues, nerves and bones of the wrist.

Finger Dislocation

If your finger is dislocated, that means a bone has been forced out of its normal position. It’s a common, painful injury, and one that needs proper treatment.

Finger Fracture

If you’ve fractured a finger, you’ve broken one or more of the finger bones we call “phalanges.” Each individual bone is called a “phalanx.” You’ve got three in each finger, and two in each thumb. They are supported by a network of soft tissues that can also be damaged during a fracture.

Fingertip Injuries

Our fingers are often in harm’s way, and our fingertips are prone to injury. A fingertip injury can involve skin, soft tissue, nerves and bone. It can involve the nail and the nailbed. These injuries can be serious, painful, and slow to heal. If you’ve injured your fingertip, you can take a few simple steps to minimize problems.

Flexor Tendon Injuries

The flexor tendons of the hand are responsible for flexion of the fingers and thumb toward the palm. These long structures are connected to the flexor muscles in the forearm. An injury to one of these tendons can cause pain and inability to flex the finger or thumb and grasp with the hand. Common flexor tendon injuries include lacerations, ruptures and inflammation.

Fractures of the Hand (Metacarpal Fractures)

This condition is a fracture, or break, of one or more of the metacarpal bones of the hand. The fracture may be nondisplaced, in which the bones remain aligned, or displaced, in which the fractured ends shift out of alignment. Without proper treatment, the bones may not heal correctly. This can result in improper alignment of the fingers, leading to poor hand function.

Ganglion Cysts of the Hand

A ganglion cyst is a fluid-filled sac that forms as a herniation from a joint capsule or tendon sheath. The sac is attached to the joint or tendon sheath by a “stalk” that allows fluid to move into the pouch from the joint or sheath. The stalk functions as a valve and often limits fluid drainage out of the cyst, allowing the cyst to increase – but not decrease – in size. In some cases the stalk functions as a two-way valve, allowing fluid to travel in both directions. This can enable the cyst to increase and decrease in size based on activities.

Mallet Finger

This condition is an injury to the end of the extensor tendon that straightens the finger’s end joint, called the DIP joint. It results in drooping of the fingertip, and prevents the finger from being straightened.

Nerve Injuries of the Hand

Complex networks of nerves travel through your hands and fingers. If you injure a hand or a finger, you can damage these delicate nerves. Without proper care, a nerve injury can cause permanent problems.

Osteoarthritis of the Hand

Osteoarthritis is the most common form of arthritis. It develops over time, often because of the wear and tear of daily activities.

Raynaud’s Phenomenon and Disease

Raynaud’s phenomenon is an exaggerated form of vasoconstriction – the body’s natural response to cold and stress. It results from a spasm of the small arteries that supply blood to the fingers. This spasm temporarily decreases blood flow, resulting in cold, painful, and discolored fingers.

Rheumatoid Arthritis (RA) of the Hand (Arthritis Foundation Approved)

Rheumatoid arthritis, a condition that can attack joints throughout the body, commonly affects the joints and surrounding tendons of the wrist and fingers. It can cause the joints to become swollen, painful and possibly deformed, interfering with normal hand function and significantly impacting a person’s quality of life.

Scaphoid Fractures

A scaphoid fracture, one of the most common types of wrist fractures, is a break in the scaphoid bone. The scaphoid, one of the most important bones in the wrist, has a limited blood supply. An improperly treated scaphoid fracture can result in significant wrist pain, arthritis, and loss of motion.

Swan Neck Deformity

This condition is a result of tendon imbalance in the finger or thumb. In the finger, it causes a characteristic deformity in which the middle finger joint (called the PIP joint) hyperextends, and the fingertip joint (called the DIP joint) bends downward. When viewed from the side, the finger looks like the outstretched neck of a swan.

Thumb Ulnar Collateral Ligament (UCL) Injury

This condition, also called skier’s thumb, is an acute sprain or tear of the ulnar collateral ligament (UCL) on the ulnar side of the metacarpal-phalangeal (MCP) joint of the thumb. A related condition, called gamekeeper’s thumb, is a chronic injury that develops over time from repeated stretching of the UCL.

Triangular Fibrocartilage Complex (TFCC) Tears

This condition is a degenerative or traumatic tear of one or more parts of the triangular fibrocartilage complex (TFCC), which stabilizes the ulna. The TFCC is composed of a group of ligaments that form connections between the radius, ulna and the carpal bones of the hand. At the center of these ligaments lies the most commonly injured structure, the triangular fibrocartilage disc, which is connected between the radius and the base of the ulnar styloid.

Trigger Digit

This common condition, also known as stenosing tenosynovitis, is a narrowing of a portion of the tendon sheath in the finger or thumb that interferes with normal finger movement. This condition most commonly affects the ring finger, but can affect any digit. It is more common in middle-aged women, but anyone can be affected, even newborns.

Volar Plate Injuries

This condition is a stretching or tearing of the volar plate, which can allow the finger to hyperextend and can interfere with normal hand function. The volar plate is a strong ligamentous structure on the underside of the finger at the point where the proximal and middle phalanx bones meet, called the proximal interphalangeal joint (or PIP joint). The volar plate keeps the finger from bending backwards at the PIP joint, and, together with the collateral ligaments, stabilizes the PIP joint from displacement.

Wrist Sprain

When your wrist is bent too far, this can injure bands of tissue called “ligaments.” Ligaments connect the bones of your hand to each other. They also connect the bones of your hand to the bones of your forearm.

Hip and Thigh

Care and Management

Bone Density Scan (DXA or DEXA)

This is a type of x-ray that measures your bone density. Your doctor may recommend it if you’re at risk for osteoporosis (that’s a weakening of your bones). This scan is a quick and easy way to check for signs of bone density loss.

Core Decompression for Avascular Necrosis of the Hip

This procedure treats avascular necrosis by removing degenerated and dead bone tissue and creating room for new, healthy tissue to grow. It typically works best for people who are in the earliest stages of the disease.

Femoroacetabular Impingement Surgery (Arthroscopic Method)

This surgery fixes problems caused by a poorly-shaped hip joint. That’s a condition known as femoroacetabular impingement. We call it “FAI.” The surgeon will repair your hip without making a large incision.

Femur Fracture Fixation (Stryker® Gamma Nail)

This procedure stabilizes severe fractures of the femur with a metal rod and screws implanted into the center of the bone. This system provides great strength while the bone heals.

Femur Fracture Fixation with Dynamic Hip Screw

This surgical procedure uses a metal plate and screws to repair a fractured femur. It retains the femoral head, allowing for more natural movement of the hip joint.

Femur Fracture Fixation with Intramedullary Rod

This surgical procedure stabilizes severe fractures of the femur by placing a metal rod into the center of the femur.

Hip Arthroscopy

This outpatient procedure is an examination of the inside of the hip joint. The surgeon uses miniature instruments and a small camera (called an arthroscope) to see inside the joint. Arthroscopy can be used to diagnose and treat problems of the joint.

Hip Fracture Treatment with Surgical Screws

This surgical procedure uses metal surgical screws to repair a fracture of the femur. This procedure is typically used for patients who have minimal damage to the bone and minimal shifting from the fracture.

Hip Hemiarthroplasty (Bipolar)

This surgical procedure replaces the head of a damaged femur with an implant designed to stabilize the femur and restore hip function. Unlike total hip replacement, in which both the ball of the femur and the hip socket are replaced, in this procedure, only the ball is replaced.

Hip Joint Injection

If you have pain in your hip, your doctor may inject medicine into your hip joint. It can help your doctor find where your pain is coming from. It can also make your hip feel better.

Internal Screw Fixation for Slipped Capital Femoral Epiphysis (SCFE)

This surgical procedure is used to stabilize a femoral head that has slipped off the neck of the femur. One or more screws are inserted through the neck and into the femoral head.

Osteoporosis Screening

As you get older, your risk for osteoporosis increases. That’s a disease that makes your bones thin and weak. A screening procedure called a “bone density test” shows if you have osteoporosis. It shows if you are likely to develop it. Or, if you are being treated for osteoporosis, it can show if your treatment is working.

Periacetabular Osteotomy

This surgical procedure is designed to relieve pain and instability of the hip caused by an abnormally shallow hip socket. In this procedure, the socket is cut and freed from the pelvis, then repositioned at an angle that stabilizes the hip and provides adequate support for the femoral head.

Stem Cell Therapy for Avascular Necrosis of the Hip

This minimially-invasive procedure is used to treat avascular necrosis of the hip (the death of bone tissue from lack of blood) with an injection of stem cells drawn from the patient’s pelvis. The stem cells promote the natural healing of the necrotic bone tissue.

Surgical Dislocation and Debridement for FAI

This procedure is used to remove excess bone growth and reshape the hip joint to allow for proper joint movement.

Total Hip Replacement

During this procedure, your damaged hip joint is replaced with implants that recreate the ball and socket of a healthy hip. This can reduce pain and restore your hip function.

Total Hip Replacement, Anterior Approach

This surgery replaces diseased and damaged portions of the hip with implants designed to restore function to the hip joint. The surgeon uses an incision on the anterolateral part of the hip, instead of a more traditional incision on the side or back of the joint.

Conditions

Anatomy of the Hip Joint

The hip joint is one of the largest weight-bearing joints in the body. This ball-and-socket joint allows the leg to move and rotate while keeping the body stable and balanced. Let’s take a closer look at the main parts of the hip joint’s anatomy.

Avascular Necrosis (Osteonecrosis) of the Hip

This is a weakening and collapse of the bone in the head of your femur. That’s the ball that fits in the socket of your hip. As this bone gradually dies and breaks apart, you can develop painful arthritis in your hip.

Bursitis of the Hip (Trochanteric Bursitis)

This is an irritation or swelling of the trochanteric bursa. This small, fluid-filled sac is found on the outer side of the femur. It acts as a cushion for the iliotibial band, a thick tendon in your leg.

Femoroacetabular Impingement (FAI)

This is a problem with the hip joint. In a healthy hip, the ball of the femur is smooth and round. It fits perfectly into the hip socket. But with this condition, the ball, the socket or both the ball and the socket are shaped poorly. They don’t fit together well. When you move your hip, they rub together harmfully.

Femur Fractures

The thigh bone, also called the “femur”, is the largest and strongest bone in your body. A femur fracture is a crack or a break of this bone.

Hip Dislocation

With this injury, the head of your femur (which is shaped like a ball) slips out of your hip socket. It may slip forward or backward out of position. This can damage structures around the joint.

Hip Fracture

This is a break of the upper part of your femur. The femur is the long bone in your upper leg. At the top of the femur is the “head.” This is the ball that fits into your hip socket. A hip fracture may happen at the “neck” of the femur (the thin portion of bone under the head). Fractures may also happen below the neck.

Hip Fracture Prevention

A broken hip is serious and disabling. With a broken hip, you may not be able to care for yourself. Sometimes, complications from a hip fracture can lead to death. Avoid a broken hip with these basic safety measures.

Iliotibial Band Syndrome (ITBS)

This is a problem on the outer side of your thigh. It’s an inflammation of the iliotibial band. That’s a thick band of tissue that spans from your hip to your shinbone. When this band becomes in inflamed, it can hurt.

Inflammatory Arthritis of the Hip

This is a type of arthritis that can affect people of all ages. It’s not the same as the most common form of arthritis, called “osteoarthritis.” That type commonly comes from wear and tear. Inflammatory arthritis can develop without any wear and tear at all.

Labral Tear of the Hip (Acetabular Labrum Tear)

If your hip joint hurts, or if it catches or clicks when you move your leg, you may have a torn labrum. That’s a rim of tissue that surrounds the hip’s socket. It helps to deepen the socket and cushion the joint. A torn labrum can keep the hip joint from working smoothly.

Loose Bodies in the Hip

Loose bodies are pieces of cartilage or bone of various sizes that have broken away and become trapped in a joint. Loose bodies usually have an irregular shape, but over time they may be worn down into a smooth, spherical or disc-shaped mass.

Osteoarthritis of the Hip

Osteoarthritis, also called degenerative arthritis, is a gradual breakdown of cartilage in the joints. Cartilage is a tough, flexible connective tissue that protects the ends of bones in the joints. Osteoarthritis is common in the hip because the hip bears the weight of the body. Osteoarthritis of the hip can severely impact a person’s lifestyle.

Osteoarthritis of the Hip

This type of arthritis, also called “degenerative joint disease,” is a breakdown of the cartilage in your hip joint. As this protective cartilage wears away, bone rubs against bone. Bony growths called “bone spurs” may form in the joint. Pain from osteoarthritis can keep you from being as active as you like.

Perthes Disease

This condition is a deformity of the femoral head caused by a temporary loss of blood supply to the hip joint. Perthes disease usually affects children between four and 10 years of age.

Slipped Capital Femoral Epiphysis (SCFE)

This is a problem with the head of the femur in growing children. With this condition, the ball-like head slips out of place in the hip socket. It moves down and back. This slip happens at the femur’s neck, along a growth plate. That’s where new bone develops. Growth plates are weaker than the surrounding bone.

Snapping Hip

This is a snapping or a popping sensation in your hip. It may happen when you stand up, when you walk, or when you move your leg a certain way.

Knee

Care and Management

ACL Reconstruction (Arthrex® TightRope®)

The anterior cruciate ligament, commonly called the ACL, is one of the ligaments that connects the femur to the tibia. During this procedure, a damaged ACL is replaced with a graft. The surgeon performs this procedure with the aid of an arthroscopic camera.

ACL Reconstruction (Patellar Tendon Graft Technique)

This procedure repairs your knee after a tear of the anterior cruciate ligament (commonly called the “ACL”). This ligament is in the center of the knee. It helps anchor the femur to the tibia. This surgery can allow you to regain normal knee function.

ACL Reconstruction with Hamstring

This procedure replaces a damaged or torn anterior cruciate ligament (ACL) with a portion of hamstring tendon from the patient’s leg. The ACL connects the front top of the tibia (lower leg bone) to the rear bottom of the femur (thigh bone). The hamstring tendons attach the hamstring muscles to the lower leg.

Arthroscopic Chondroplasty

This outpatient procedure is used to repair a small area of damaged cartilage in the knee. The damaged tissue is removed, allowing healthy cartilage to grow in its place. It is performed through small incisions on the sides of the knee with the aid of a small video camera called an arthroscope.

Arthroscopy (Overview)

If you have a joint problem, your surgeon may want to try arthroscopy. This lets your surgeon see inside your joint with a small, thin camera called an “arthroscope.” It can be used on any joint, but let’s see it in the knee.

Arthrosurface® HemiCAP® Resurfacing

This arthroscopic procedure uses a small, metal, cap-like implant to cover damaged or missing articular cartilage in the knee joint. The articular cartilage covers the surfaces of the bones in the joint, allowing them to glide smoothly against each other. The procedure can typically be performed in about an hour.

Autologous Chondrocyte Transplantation

This surgical procedure replaces damaged cartilage in the knee joint with healthy cartilage cells. These cells are harvested from healthy portions of the knee and are grown in a lab for implantation. This procedure is usually performed in two stages, with two separate surgeries.

Cartilage Repair

This technique is designed to treat and repair cartilage defects by regenerating the patient’s own hyaline cartilage, (a weight-bearing cartilage that lines the surface of the knee joint).

Genicular Nerve Ablation (RF Neurotomy)

During this outpatient procedure, the physician uses a radiofrequency device to heat up and disrupt the genicular nerves. These are the sensory nerves that transmit pain signals from the knee to the brain. Disrupting these pathways can provide long term relief from knee pain.

Genicular Nerve Block (G Block)

This outpatient procedure is an injection of anesthetic to the genicular nerves. These are the sensory nerves that transmit pain signals from the knee to the brain. Anesthetizing these nerves can disrupt the pain signals caused by degeneration of the knee. A genicular nerve block can provide temporary pain relief. It may help determine if a patient is a candidate for nerve ablation, which can provide long-term pain relief.

High Tibial Osteotomy

This procedure removes a wedge of bone from the tibia, straightening the leg and correcting the deformity known as bow-leggedness.

HYALGAN® Injection for Knee Pain (Fluoroscopic Guided)

This is an injection of a medicine called HYALGAN. It’s delivered directly into your knee joint. It helps with the pain of osteoarthritis.

Loose Body Removal (Knee)

During this minimally-invasive outpatient procedure, the surgeon removes debris from within the knee joint. This debris is usually a piece of bone, cartilage or other tissue that has broken free and is floating within the joint.

Meniscal Transplant

This outpatient procedure is performed to replace lost or severely damaged meniscal cartilage in the knee joint. In a healthy knee, this cartilage is present in two c-shaped wedges called menisci. Each one is called a meniscus. These wedges help cushion and stabilize the knee. This procedure is performed under general anesthesia with the aid of a small camera, called an arthroscope, and miniature instruments.

Meniscus Repair (Arthroscopic Technique)

Each of your knee joints is cushioned by two c-shaped wedges of cartilage. The two cushions in each knee are called the “menisci.” Individually, each cushion is called a “meniscus.” Certain motions, such as twisting the knee, can cause a meniscus to tear. In many cases, a torn meniscus can be treated with arthroscopic surgery.

Microfracture Drilling Procedure for Isolated Chondral Defect

This minimally-invasive procedure repairs damaged cartilage in the knee joint. Small holes are drilled into the bone at the base of the damaged area to stimulate the growth of healthy “scar” cartilage.

OATS Cartilage Repair Surgery

This procedure replaces areas of damaged cartilage with grafts of the patient’s own healthy hyaline cartilage. The procedure, also known as mosaicplasty, is performed using small instruments through incisions on the sides of the knee. The surgeon uses a small video camera called an arthroscope to see inside the joint and guide the instruments.

Partial Knee Replacement (using OXFORD® implant)

Unlike total knee replacement surgery, this less invasive procedure replaces only the damaged or arthritic parts of the knee. The OXFORD® unicompartmental knee uses metal and plastic implants designed to potentially last longer and wear down less easily than traditional implants.

Partial Meniscectomy

The meniscus is a cushion of cartilage. There are two in each knee. If one of these shock absorbers is worn out or hurt, you may need a partial meniscectomy to remove the damaged areas.

Patellofemoral Replacement

This surgical procedure removes portions of damaged cartilage on the femur in the knee joint that have been rubbing against the underside of the patella, causing pain and loss of mobility. This cartilage is then replaced with a specially-designed implant.

Posterior Cruciate Ligament (PCL) Reconstruction

This surgical procedure replaces a damaged posterior cruciate ligament (PCL). The PCL is a band of tissue that connects the femur to the tibia inside the knee.

Stem Cell Therapy for Knee Pain

If you have injured your knee, or if normal wear and tear has caused degeneration of your joint, stem cell therapy may help. It uses parts of your own blood to help repair knee damage. It may help you avoid surgery.

Stem Cell Therapy for Nonunion Fracture of the Tibia

This minimially-invasive procedure is used to treat a fracture of the tibia that has failed to heal after several months with an injection of stem cells drawn from the patient’s pelvis. The stem cells promote the natural healing of the fracture.

Tibial Osteotomy with Closed Wedge

This surgical procedure is used in cases where osteoarthritis has affected only one side of the knee joint. The tibia is cut and realigned so that pressure is shifted from the damaged side of the knee joint to the healthier side.

Tibial Osteotomy with Open Wedge

This surgical procedure is used in cases where osteoarthritis has affected only one side of the knee joint. The tibia is cut and realigned so that pressure is shifted from the damaged side of the knee joint to the healthier side.

Tibial Tubercle Osteotomy

This procedure, also called bone realignment, is designed to improve the movement of the patella (the kneecap) to correct patellar tracking disorder. The procedure usually requires hospitalization and general anesthesia.

Total Knee Replacement

This procedure restores function to a severely damaged knee. Most commonly, it is used to repair a knee that has been damaged by arthritis. During the procedure, the surgeon replaces the damaged portions of the knee with artificial parts. These parts consist of a metal femoral component, a metal tibial component and a plastic spacer. A small plastic patellar component may also be used.

Viscosupplementation for Arthritis of the Knee

This is an injection of medicine into the knee joint. It lubricates your knee so the bones can glide smoothly. It can help lessen the pain of arthritis.

Conditions

Anatomy of the Knee

The knee is the body’s largest joint. It’s the place where three bones meet: the tibia, the femur and the patella. The knee is a “hinge” joint. It allows the leg to bend in one direction only. Let’s take a closer look at the main parts of the knee’s anatomy.

Anterior Cruciate Ligament (ACL) Injuries in Women

The anterior cruciate ligament, commonly called the ACL, is a thick, elastic band of tissue that runs from the bottom of the femur to the top of the tibia. It helps stabilize the knee joint. The ACL can become stretched or torn when the knee is twisted or hyperextended. For reasons that are not fully understood, ACL injuries are much more common in women than in men.

Anterior Cruciate Ligament Tear (ACL Tear)

This injury is a tearing of the ACL ligament in the knee joint. The ACL ligament is one of the bands of tissue that connects the femur to the tibia. An ACL tear can be painful. It can cause the knee to become unstable.

Avascular Necrosis (Osteonecrosis) of the Knee

This condition occurs when a bone’s normal blood supply is disrupted. The affected bone cells die and the dead bone weakens. The bone may begin to fracture and collapse, leading to arthritis.

Bursitis of the Knee (Pes Anserine Bursitis)

This is a swelling of a fluid-filled sac called a “bursa.” It’s on the inner side of your knee, between the tibia and the tendons that attach to your hamstring muscle. You have similar sacs near other large joints throughout your body. They act as cushions between your bones and your soft tissues. Normally they have a small amount of fluid inside them. But sometimes they can swell. We call that “bursitis.”

Deep Vein Thrombosis (DVT)

This condition is a blood clot that forms in a vein deep inside the body. This type of clot most commonly develops in the legs. This condition is dangerous, because the clot can break free and travel through the bloodstream to the lungs.

Fractures of the Tibial Spine

This condition is a fracture of a portion of the tibia, also called the shin bone, in the knee joint. The tibial spine is a specialized ridge of bone in the tibia where the anterior cruciate ligament (ACL) attaches. This ligament is important in maintaining flexibility and stability in the knee.

Iliotibial Band Syndrome (ITBS)

This is a problem on the outer side of your thigh. It’s an inflammation of the iliotibial band. That’s a thick band of tissue that spans from your hip to your shinbone. When this band becomes in inflamed, it can hurt.

Meniscus Tear

This is a common injury of the knee. Your knee joint is cushioned by two c-shaped wedges of cartilage called the “menisci.” Each individual cushion is called a “meniscus.” This injury is a tear of one of these cushions.

Osgood-Schlatter Disease

This is a type of injury that causes knee pain in children. It’s an inflammation of a growth plate in the tibia. Growth plates are places where new bone tissue forms. They are found in the long bones of growing children. But growth plates are weaker than the surrounding bone. That makes them easier to injure.

Osteoarthritis of the Knee

Osteoarthritis, also called degenerative arthritis, is a gradual breakdown of cartilage in the joints. Cartilage is a tough, flexible connective tissue that protects the ends of bones in the joints. Osteoarthritis is common in the knees because the knees bear the weight of the body. Osteoarthritis of the knee can severely impact a person’s lifestyle.

Osteochondritis Dissecans of the Knee

This condition is characterized by the death of an area of cartilage and bone in the knee joint. The dead section may remain in place, forming a lesion, or it may loosen and partially detach from the surrounding bone. It may break away completely and float around inside the joint.

Patellar Fracture

This is a break of the patella. That’s the small bone in the front of your knee often called the “kneecap.” The kneecap protects the joint and helps link your thigh muscles to your lower leg. A fracture can cause pain and other problems.

Patellar Tendinitis

This is a pain you feel just below your patella (the bone we commonly call the “kneecap”). It’s an injury to your patellar tendon, which connects the bottom of the kneecap to the shinbone.

Patellar Tendon Tear

This is a tear of a large tendon in the front of your knee. We call it the “patellar tendon.” It connects the bottom of the kneecap to the top of the shinbone. It helps you straighten your leg. You can have a tear that doesn’t go all the way through the tendon, or you can tear the tendon completely. A complete tear is a disabling injury.

Patellar Tracking Disorder

This is a problem with the alignment of the patella (the bone at the front of the knee, commonly called the “kneecap”). With this disorder, the patella shifts out of its normal track as you bend or extend your knee.

Patellofemoral Pain Syndrome

This is a pain you feel in the front of your knee. It involves the patella. That’s the bone we commonly call the “kneecap.” The patella slides up and down in a groove on your femur as you bend and extend your knee. If you have this syndrome, you may have injured the soft tissues that support and cushion your kneecap. Or, you may have some damage to the cartilage on the underside of the kneecap.

Posterior Cruciate Ligament (PCL) Injuries

Strong bands of tissue called “ligaments” help stabilize the bones that form the knee joint. One of these ligaments is called the “PCL.” It helps connect the femur to the tibia. If you stretch or tear a PCl, your knee may become unstable.

Prepatellar Bursitis (Kneecap Bursitis)

This condition is an inflammation of the prepatellar bursa, a fluid-filled sac that covers the front of the kneecap. Prepatellar bursitis results in pain and swelling at the front of the knee.

Quadriceps Tendon Tear

This condition is a tear of the tendon that connects the patella to the quadriceps muscles of the thigh. The quadriceps muscle is used to straighten the leg from the bent position. A complete rupture of the quadriceps tendon is a disabling injury.

Septic Arthritis (of the Knee)

This is an infection in the knee joint. It causes your knee to become painfully inflamed. Without proper treatment, it can become a chronic problem. It can permanently damage your knee.

Shin Splints (Medial Tibial Stress Syndrome)

This is pain you feel in the front of one or both of your lower legs. It can be a problem for runners, dancers, gymnasts and other active people.

Tibial Fractures

This is a break of the shinbone. That’s the larger of the two bones in the lower leg. Tibias are strong bones that support most of your body’s weight.

Tibial Plateau Fracture

This condition is a fracture at the top of the tibia, also called the shin bone. This fracture usually involves both bone and cartilage, so there is a high risk of developing arthritis from injury to the cartilage cells.

Shoulder

Care and Management

Acromioclavicular (AC) Joint Separation Repair

This surgery repairs a severe separation injury of the AC joint in your shoulder. This is where your clavicle meets your scapula. With a severe separation injury, the ligaments that connect these bones are torn. The clavicle shifts out of position.

Arthroscopic Capsular Plication

This minimally-invasive surgery is used to relieve pain and loss of shoulder stability for patients with loose shoulder. A radiofrequency (RF) probe is inserted into the shoulder to stimulate the tissue capsule that surrounds the shoulder joint. This causes the tissue to contract, tightening the shoulder joint.

Arthroscopic Capsular Release

This minimally-invasive surgery is used to help relieve pain and loss of mobility in the shoulder from adhesive capsulitis (frozen shoulder). A radiofrequency (RF) probe is inserted into the shoulder. The probe uses RF waves to cut the tissue capsule that surrounds the shoulder joint, allowing the shoulder to move more freely.

Bankart Repair

If you have a painful shoulder, you may have a torn labrum. That’s a tear of the thick band of tissue around your shoulder socket. A torn labrum can be fixed with a procedure called a “Bankart repair.”

Biceps Tenodesis

This surgery repairs a biceps tendon in your shoulder. It fixes a tendon that is partially torn, or completely torn, from the bone.

Diagnostic Arthroscopy (Shoulder)

This outpatient procedure is a minimally-invasive surgical technique commonly used to identify problems in the shoulder joint. It is performed with the aid of a specialized camera called an arthroscope.

Distal Clavicle Excision (Resection, Arthroscopic Technique)

During this minimally-invasive procedure, the surgeon removes the end of the clavicle at the acromioclavicular joint in the shoulder. Removing this portion of bone will decompress the joint. It will help relieve the pain and loss of motion caused by arthritis or impingement. This procedure is performed with a small camera, called an arthroscope, and miniature instruments.

Glenohumeral Debridement

This minimally-invasive procedure is used to remove tissue in the shoulder joint that has been damaged from arthritis, overuse or injury. The physician uses a small camera, called an arthroscope, which is inserted into the shoulder joint.

Joint Injection (Therapeutic, Shoulder)

This outpatient injection procedure relieves pain in the shoulder and arm caused by arthritis, injury or disorder.

Mini-Open Rotator Cuff Repair

This surgical procedure is used to inspect and reattach torn tendons in the shoulder’s rotator cuff. The initial part of the surgery is performed arthroscopically through small tubes. An open incision may be needed if the damage is severe.

ORIF Surgery for Proximal Humerus Fracture

This surgical procedure repairs a break in the proximal end of the humerus. ORIF stands for Open Reduction Internal Fixation. During this procedure, an incision will be made and a metal plate will be attached to the humerus to hold the bone in place while it heals.

Reverse Total Shoulder Replacement

During this procedure, the surgeon replaces a damaged shoulder joint with artificial components that reverse the structure of the shoulder. This procedure is most often used for patients who have had a failed total shoulder replacement. It is also helpful for patients who have had a complete tear of the rotator cuff, especially those whose injuries have led to an arthritic condition called cuff tear arthropathy.

Rotator Cuff Repair (Arthroscopic)

This surgery repairs a tear of the rotator cuff in your shoulder. The rotator cuff is group of muscles and tendons. It holds the head of the humerus in the shoulder socket.

This surgical procedure is used to repair a torn supraspinatus tendon, one of the tendons that forms the rotator cuff of the shoulder. During this procedure, the tendon is reattached firmly to the head of the humerus.

Shoulder Resurfacing

This surgery replaces the damaged or diseased part of the humerus head (also known as the ball) with a metal implant.

SLAP Repair

This arthroscopic procedure is performed to repair a tear of the biceps tendon at the point where it connects to the labrum, a ring of cartilage that surrounds the shoulder socket. A tear at this point is called a SLAP (Superior Labrum Anterior-Posterior) tear. SLAP repair is performed under general and regional anesthesia, and patients usually leave the hospital the same day.

Subacromial Decompression

This surgery treats subacromial impingement. That’s a pain you feel when you raise your arm. It happens when tendons in your shoulder press and rub against a part of your shoulder blade called the “acromion.” This surgery is commonly done with the help of a special camera called an “arthroscope.”

Subacromial Injection

This injection goes into your shoulder. It can help reduce your shoulder pain. We use it to treat many conditions. It’s used for adhesive capsulitis, rotator cuff tendinosis and impingement syndrome.

Total Shoulder Replacement

This surgery replaces the damaged or diseased head of the humerus (also called the ball) and cartilage from the shoulder joint with a metal and plastic joint.

Conditions

Acromioclavicular (AC) Joint Arthritis

This condition, also called AC joint arthrosis, is a degeneration of the joint at the top of the shoulder where the acromion meets the clavicle.

Anatomy of the Shoulder

The shoulder is a complex structure made of three separate joints. They work together to give the shoulder a tremendous range of motion. Let’s take a closer look at the main parts of the shoulder’s anatomy.

Biceps Tendon Tear (at the Shoulder)

Tendons are strong bands of tissue that connect muscle to bone. With this injury, one of the tendons anchoring your biceps muscle is torn. It may be torn partially or completely. Because the biceps is attached with two separate tendons, you may find that you can still use your biceps muscle even if one tendon is completely torn.

Biceps Tendonitis

This is a problem with a tendon in your shoulder. Most often, it’s the “long head of biceps” tendon. It travels from the front of your upper arm to the top of your shoulder socket. With this condition, the tendon becomes painfully inflamed or irritated.

Burners and Stingers

These are warm or painful sensations caused by an injury to the brachial plexus. This is a network of nerves that passes through your shoulder. They travel down your arm and to your hand.

Bursitis of the Shoulder (Subacromial Bursitis)

This is a swelling of a fluid-filled sac called the “subacromial bursa.” It’s in the shoulder, between a bony protrusion called the “acromion” and the rotator cuff. You have similar sacs near other large joints throughout your body. They act as cushions between your bones and your soft tissue. Normally they have a small amount of fluid inside them. But sometimes they can swell. We call that “bursitis.”

Calcific Tendinitis of the Shoulder (Degenerative Calcification)

This painful condition occurs when calcium deposits form in tendons of the rotator cuff. These tendons and surrounding tissues in the shoulder become inflamed. This condition typically affects adults.

Calcific Tendinitis of the Shoulder (Reactive Calcification)

This painful condition occurs when calcium deposits form in tendons of the rotator cuff. These tendons and surrounding tissues in the shoulder become inflamed. Reactive calcification often develops in young people, but it can affect people of all ages.

Clavicle Fracture (Broken Collarbone)

This is a common shoulder injury. It’s a break of the bone that rests between the shoulder blade and the sternum. We call it the “collarbone.” Your collarbones help connect your arms to your body.

Fracture of the Shoulder Socket (Glenoid Fracture)

This is a fracture of a part of the shoulder blade called the “glenoid.” This is the socket that holds the head of the humerus (the bone of the upper arm). A glenoid fracture can allow the head of the humerus to slip out of the socket.

Fractures of the Greater Tuberosity

This condition is a fracture of the bony bump that is located opposite of the head of the humerus. This type of fracture can interfere with the rotator cuff.

Frozen Shoulder (Adhesive Capsulitis)

This is stiffening of your shoulder. It happens over time, and you may not know what caused it. With a frozen shoulder, it can be hard for you to be as active as you like.

Glenoid Labrum Tear

If you have pain in your shoulder, you may have a torn labrum. That’s the thick band of tissue that goes around your shoulder socket. It helps make the socket deeper. It cushions the bone of your upper arm and keeps it from slipping.

Hill-Sachs Lesion

This condition is a traumatic fracture of the humeral head that leaves an indentation in the bone. This changes the shape of the humeral head and can interfere with normal arm motion.

Osteoarthritis of the Shoulder

Osteoarthritis, also called degenerative arthritis, is a gradual breakdown of cartilage in the joints. Cartilage is a tough, flexible connective tissue that protects the ends of bones in the joints. Osteoarthritis of the shoulder can severely impact a person’s lifestyle.

Proximal Humerus Fracture (Broken Shoulder)

This condition is a fracture of the head of the humerus – the “ball” of the shoulder’s ball-and-socket.

Rotator Cuff Injuries

Rotator Cuff Tear

The rotator cuff is a group of muscles and tendons in each shoulder. It holds your upper arm bone in your shoulder socket. It keeps your arm stable while allowing it to lift and rotate. Too much stress on the rotator cuff can cause a tear. This can be a painful injury.

Shoulder Dislocation

The shoulder is a ball-and-socket joint. The ball of your upper arm bone fits into a socket in your shoulder blade. If the ball slips out, your shoulder has “dislocated.”

Shoulder Impingement Syndrome

This is a painful pinching of soft tissues in your shoulder. It happens when these tissues rub and press against a part of your shoulder blade called the “acromion.” This can irritate your rotator cuff tendons, and also a soft sac called the “subacromial bursa.”

SLAP Tear (Superior Labrum from Anterior to Posterior Tear)

This is a shoulder injury. It’s a tear of the labrum. That’s a ring of cartilage that surrounds the shoulder socket and helps hold the head of the humerus in place. This type of tear happens where the biceps tendon attaches to the labrum.

Snapping Scapula Syndrome

This is a problem that involves the scapula. That’s the bone we call the “shoulder blade.” With this condition, you have a shoulder blade that catches when you lift or move your arm. You may find this only slightly irritating, or it may be very painful.

Spine

Conditions

Anatomy of the Spine

The spinal column is the body’s main support structure. Its thirty-three bones, called vertebrae, are divided into five regions: cervical, thoracic, lumbar, sacral and coccygeal.

Cervical Radiculopathy

This condition is an irritation or compression of one or more nerve roots in the cervical spine. Because these nerves travel to the shoulders, arms and hands, an injury in the cervical spine can cause symptoms in these areas. Cervical radiculopathy may result from a variety of problems with the bones and tissues of the cervical spinal column.

Compression Fractures of the Spine

This is a collapse of vertebral bone. It can affect one or more vertebrae. Compression fractures typically develop in your mid or lower back. This can change the shape of your spine.

Degenerative Disc Disease

This condition is a weakening of one or more vertebral discs, which normally act as a cushion between the vertebrae. This condition can develop as a natural part of the aging process, but it may also result from injury to the back.

Facet Joint Syndrome

This condition is a deterioration of the facet joints, which help stabilize the spine and limit excessive motion. The facet joints are lined with cartilage and are surrounded by a lubricating capsule that enables the vertebrae to bend and twist.

Herniated Disc (Cervical)

This condition is a rupture of one of the vertebral discs in your neck. A herniated disc can allow disc material to press harmfully against the spinal nerves.

Herniated Discs

A herniated disc is a common injury that can affect any part of the spine. A herniated disc can cause severe pain and other problems in the arms or legs.

Kyphosis

This condition is a deformity of the spine. With it, your vertebrae change from a cylindrical shape to a wedge shape. Your spine may begin to curve forward. Eventually, this gives your upper back a rounded appearance.

Lumbar Radiculopathy (Sciatica)

This condition is an irritation or compression of one or more nerve roots in the lumbar spine. Because these nerves travel to the hips, buttocks, legs and feet, an injury in the lumbar spine can cause symptoms in these areas. Sciatica may result from a variety of problems with the bones and tissues of the lumbar spinal column.

Myelopathy

This is a problem that affects your spinal cord. It happens when something presses harmfully against it. Your spinal cord is the main nerve pathway between your brain and your body. Pressure on it can cause problems throughout your body.

Scoliosis

This condition is an abnormal curvature of the spine. It most often develops in early childhood, just before a child reaches puberty.

Spinal Stenosis

The spinal column contains open spaces that create passageways for the spinal cord and the spinal nerves. Spinal stenosis is a narrowing of (or an intrusion into) these openings. This can cause a compression of the nerves. Spinal stenosis most commonly affects the cervical and lumbar regions of the spine.

Spinal Stenosis (Cervical)

This condition is a narrowing of the spinal canal that results from the degeneration of bones, discs, or joints in the cervical spine.

Spinal Stenosis (Thoracic)

This condition affects the thoracic spine between the neck and the lower back. It is a narrowing of the spinal canal that results from degeneration of bones in the spine, disc herniation, or thickening of the tissues that surround the spinal cord.

Spondylolisthesis

This condition occurs when a lumbar vertebra slips out of place. It slides forward, distorting the shape of your spine. This may compress the nerves in the spinal canal. The nerves that exit the foramen (open spaces on the sides of your vertebrae) may also be compressed. These compressed nerves can cause pain and other problems.

Spondylosis

This condition is a degeneration of the spine that can affect the spine at any level, resulting in pain and discomfort that can grow worse over time.

Where Lower Back Pain Begins

Lower back pain is a common problem that severely impacts the quality of your life. It can limit your ability to be active. It can cause you to miss work. Many different causes may lead to pain in your lower back.

Where Neck Pain Begins

Neck pain is a common problem that severely impacts the quality of your life. It can limit your ability to be active. It can cause you to miss work. Many different causes may lead to pain in your neck.

Whiplash

This is a common neck injury. It happens when your neck jerks back and forth quickly and violently. Your spine bends past its normal range of motion. This can injure the vertebrae of your cervical spine. It can damage the supporting ligaments and muscles in your neck.

About Yaser El-Gazzar, MD

He is a Board Eligible, orthopedic surgeon with specialty interests in joint preservation, adult & pediatric sports medicine, and trauma.